The Orthodontic CYBERjournal

Counterpoint Software


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COUNTERPOINT SOFTWARE, INC.
800 E. Dimond Blvd., Suite 3-415 Anchorage, Alaska 99515 Phone: 1-800-525-8783


ABOUT THE COMPANY:

CounterPoint Software, Inc. was formed by a senior information technology professional and a healthcare professional for the specific purpose of developing new computer software for the self-administration and third party administration of self-insurance and direct reimbursement employee benefit plans. Our objective is to give companies throughout the U.S. a cost effective alternative to other types of healthcare benefit plans by providing them with state-of-the-art administrative software to manage their in-house benefit plans.

CounterPoint Software specializes in providing software for any company's self-insurance health benefit needs, regardless of the company size or benefits being offered. Whether the company utilizes a modern stand-alone single user computer system or a client/server application and database, we have the technological expertise to provide solutions to the problems in healthcare benefits management. As software consultants, we are required to be knowledgeable in many aspects of a complex, interwoven web of computer technologies, especially since the recent migration to distributed computing has made computer application development more powerful and more complex than ever before.

In the future, managing healthcare benefits may become a matter of utilizing distributed computing technology via local and area wide networks like the InterNet. CounterPoint Software, in looking to the future, has the expertise to meet the upcoming challenges associated with such advancements in technology.

In the business of healthcare benefits, what sets us apart from others is the background and caliber of each member of our development team. Each has had a long and distinguished career before starting CounterPoint Software. With diverse experience in engineering, medicine, business and data processing, we are knowledgeable in the latest techniques and technologies as well as being seasoned in the proven, traditional fundamentals and methodologies. In a project such as this, our considerable experience allows us to side step many of the pitfalls that can engulf the less experienced.

Our philosophy is to provide our clients with the highest quality software for the management of their employee benefit plans. We will listen carefully to their concerns and consider all of the factors that influence their benefit plans. Further, we will take that information and use it as a guideline for future enhancements of the software.

CounterPoint Software is a team of individuals who take pride in their work and find satisfaction in creating the best possible products for their clients.


BACKGROUND

Since the advent of third party payer systems, more Americans than ever before have received medical and dental care as a benefit provided by their employers. The need for expanded numbers of medical providers became apparent and the growth of the healthcare field mushroomed. With prosperity came inflation and the threat of frivolous lawsuits by patients. The result has been a medical community that has been forced to provide higher levels of liability insurance coverage and treatment that has been considered by some to be unnecessary due to the need to protect itself against the threat of litigation. Over the years, the cost of healthcare and insurance premiums for employee healthcare benefits have continued to rise at an alarming rate. The insurance company's' answer has been to reduce costs to the employer by controlling the treatment that can be rendered to patients by the providers and control the fees that providers can charge. The answer proposed by the American Association of Orthodontists (AAO), the American Dental Association (ADA) and the Alliance for Dental Reimbursement Plans (ADRP) has been the implementation of Direct Reimbursement plans, the simplest form of self-insurance that provides freedom of choice for patients, eliminates costly administration by the insurance companies and directs those dollars to patient care.


TARGET GROUPS

The concept of Direct Reimbursement is being promoted most heavily in the area of dental benefits, and to a lessor extent in vision and medicine. With the onslaught of managed care programs in the U.S., it seems that the time is right for Direct Reimbursement to move forward. Since dentistry's primary attribute is the fact that its costs are non-catastrophic in nature and very predictable year after year, the promotion of Direct Reimbursement for dental benefits makes the most sense as a starting point for many companies. Having dentistry as the target group for the promotion of Direct Reimbursement, CounterPoint Software's goal is to become a primary software consultant to the AAO, ADA, ADRP and each of the fifty state dental societies for the purpose of providing state-of-the-art computer software for the promotion and implementation of Direct Reimbursement plans.

PRODUCTS

Our family of products, called Self-Insurance ManagerTM, have been designed for those companies that wish to self-administer their own in-office benefit plans. The new software is geared for companies that range in size from two employees to several thousand. While it is likely that most companies will begin with a Direct Reimbursement plan directed toward dental benefits, Self-Insurance ManagerTM provides each company with the ability to ultimately expand their benefit programs to include medical, vision and chiropractic coverage. When a company decides to add one or more of the other plans, all that is required of the plan administrator is to determine the annual maximum benefit, how the benefits are to be paid out (i.e. the design of the payment tiers) and then assign an employee group to the new plan. Employees can then begin to utilize the expanded benefits plan. Self-Insurance ManagerTM tracks each plan independently and provides the plan administrator with detailed reports to easily monitor its progress through the year.

CounterPoint Software, Inc. currently markets two products for the self-administration and third party administration of self insurance and direct reimbursement benefit plans.

The two products are:

Self-Insurance ManagerTM-Direct Reimbursement Edition (SIM DRTM)

Self-Insurance ManagerTM-Self Administration Edition (SIM SATM).

SIM DRTM is a version of the software that is specifically designed for a single company that wishes to self-administer their own direct reimbursement dental benefit plan. SIM DRTM is fully upgradeable to SIM SATM, the version of the software can be used for both the self-administration and third party administration of all types of health benefit plans including dental, medical, vision, chiropractic and any type of custom health or safety plan. SIM SATM has the capability of combining simple benefit plans for one type of medical category with more complex plans for another type of medical category. SIM SATM provides many expanded functions not found in the simpler direct reimbursement version.

In the future, CounterPoint Software, Inc. plans to release a third product.

Self-Insurance-ManagerTM-Third Party Administration Edition (SIM TPATM)

SIM TPATM will be a version of the software specifically tailored to the needs of third party administrators. Special client billing features and cost projection utilities will be incorporated in SIM TPATM. The future release of SIM TPATM will be an important step in the promotion of Direct Reimbursement. The software will give TPA's the ability to manage dozens of companies and thousands of employees will relative ease. Additional features specific to the needs of third party administrators will eliminate the need for importing and exporting information from databases to spreadsheets to word processing systems and back again, thereby making their jobs easier and less prone to errors. In the meantime, SIM SATM will serve the needs of third party administrators quite nicely and will be fully upgradeable to SIM TPATM.

The marketing of these products will help give companies throughout the U.S. a cost-effective alternative to the restrictive managed care plans that are now being offered by the insurance companies. The need for cost containment by these companies has been apparent, but the idea of forcing doctors to absorb all of the cost reductions is not the answer. The answer lies within the free market economy that has worked so well within the U.S. for some 200 years. Empowering the people to make their own decisions about how their money is spent on healthcare is the key to the solution, an important ingredient of America's free market system that helps keep high priced goods and services in check.

It is CounterPoint Software's goal to provide the highest quality software for benefit plan management to minimize client questions so that they can administer their plans as effortlessly as possible. By listening intently to suggestions from our clients and software resellers, we will identify additional features that will help expand the functionality of the software and simplify the task of managing benefit plans.

For those clients that need technical assistance once the new software is installed, CounterPoint Software has an 800 number technical support line. Technical support services can be purchased and upgrades will be issued on an annual basis for a nominal fee.

CounterPoint Software will continue to support this very important project that is aimed at saving companies money on their health care programs, preserving freedom of choice for patients, retaining fee-for-service dentistry, and allowing providers to compete for any willing patients in a free market system. This is a project to help preserve the American way!


Self-Insurance ManagerTM

Comparison Matrix


SOFTWARE EDITION

Direct Reimbursement

Self-Administration

 

SIM DR

SIM SA

COVERAGE FEATURES

 

 

Pure Direct Reimbursement

YES

YES

Modified Direct Reimbursement

NO

YES

Ability to Mimic Indemnity Plans

NO

YES

Dental Category Coverage

YES

YES

Medical Category Coverage

NO

YES

Vision Category Coverage

NO

YES

Chiropractic Category Coverage

NO

YES

Custom Category Coverage

NO

YES

Individual or Family Coverage

YES

YES

Individualized Plan Selection

YES

YES

 

 

 

DESIGN FEATURES

 

 

Automated COBRA period

NO

YES

Automated Eligibility Period

NO

YES

Checking for Eligibility

YES

YES

Checks Compatibility

DELUXE bus. forms

DELUXE Bus. Forms

Checks to Emplyees

YES

YES

Checks to Providers

YES

YES

Claim Editing

YES

YES

Client Billing Alternative

NO

NO

Custom Dependent Types

YES

YES

Deductibles in Payment Tiers

YES

YES

Duplicate Claims Checking

YES

YES

Employee Account

NO

YES

Employee Groups

NO

Multiple

Medical & Dental Subcategory Limitations

NO

YES

Multiple Open Accounting Periods

YES

YES

Number of Companies

One

Unlimited

Number of Employees

Unlimited

Unlimited

Payroll Deduction Tracking Req'd and Elective

NO

YES

Pre-Tax and After Tax Tracking

YES

YES

Procedure Code Limitations

NO

YES

Restrict Editing to Open

YES

YES

Sample Company

On Demo Only

YES

Single or Multiple Payment Tiers

YES

YES

Single or Multiple Plans

YES

YES

Standard Accounting Formal

YES

YES

 

 

 

REPORTING FEATURES

 

 

Built-in Reports

20

26

Custom Reports w/ Custom Report Writer

Available

Available

Electronic Stickie Notes and Annotations

YES

YES

Fee Data Compiled Based on Submitted Claims

YES

YES

Graphical Management Reports

NO

FUTURE

Printing EOB's w/Print Preview

YES

YES

Provider Tracking

YES

YES

Retired Employee Tracking

NO

YES

 

 

 

SYSTEM FEATURES

 

 

3-D Graphical User Interface

YES

YES

Automated Installation

YES

YES

Drag and Drop Features

YES

YES

Export Function

Future

Future

Import Function

Future

Future

ODBC Compatible Relational Database

YES

YES

Open Multiple Windows

YES

YES

Password Protection

NO

Future

Support Multi-User Environment

NO

Future

Type-ahead Fields

YES

YES

Windows Operating Systems Supported

3.1--NT--95

3.1--NT--95

 

 

 

ADD-ON FEATURES

 

 

ADA Codes

Built-in

Built-in

AMA CPT Codes

NO

Available

HCPCS Codes

NO

Available

 

 

 

SUPPORT FEATURES

 

 

800# Technical Support

YES

YES

On-Line Automatic Field Description

YES

YES

On-Line Help Files

Future

Future

Release Date

Released

Released

Technical Support and Upgrades

YES-Purchase Option

YES-Purchase Option

Upgradeable to Next Version

YES

YES

Price of Software (excluding support and Updates)

$675.00

$995.00


THREE EASY WAYS TO ORDER:



PRODUCTS

Self-Insurance Manager - Self Administration

$995.00

Next Version Upgrade Subscription, Pre-Release Price @ $299.00

Self-Insurance Manage Direct Reimbursement

$675.00

Next Version Upgrade Subscription, pre-release price @ $199.00

One Year Technical Support Agreement

$149.00

 

 

 

 

Shipping and Handling

$10.00

 


If ordering by mail or FAX be sure to include:

CounterPoint Software

CounterPoint's Web Site with detailed information about Direct Reimbursement and their software products.


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